*  83 The Effects of Training and Detraining on T Wave Inversion in a Cohort of Athletes | Heart
Purpose T wave inversion (TWI) is the electrical hallmark of cardiac conditions such as hypertrophic cardiomyopathy (HCM) or arrhythmogenic right ventricular cardiomyopathy (ARVC), which may be the substrate for sudden cardiac death in the young athlete. Such repolarization anomalies can feature on the ECG of an apparently healthy athlete and pose major diagnostic dilemmas in sports cardiology, as regular, prolonged high intensity, physical activity is associated with such repolarization changes. Athletes themselves are reluctant to detrain during the season, which makes interpreting any reversible effects of exercise on the ECG more difficult. This study aimed to investigate the effect of detraining on TWI in athletes. ...
  http://heart.bmj.com/content/101/Suppl_4/A45.2
*  Abstract 18757: Sport-Specific Prevalence of Right Precordial T Wave Inversions in Caucasian Athletes and Associated...
Introduction: While right precordial T wave inversions (RPTWI) are associated with specific cardiomyopathic conditions including ARVC, they are common among trained athletes without underlying heart disease. RPTWI in athletes, particularly those that are not of Afro-Caribbean descent, remain poorly understood and represent a source of considerable clinical controversy. We therefore sought to examine the prevalence, training physiology specificity, and ECG correlates of RPTWI among asymptomatic Caucasian athletes.. Methods: Competitive collegiate Caucasian male endurance athletes (rowers, n=168) and strength-trained athletes (football players, n=162) underwent standard 12-lead ECG at the time of pre-participation screening. ECGs were analyzed for standard quantitative parameters and for the presence of RPTWI defined as TWI ≥2mm in ≥2 leads from V1 to V3.. Results: RPTWI were significantly more prevalent in endurance athletes (25%) than in strength-trained athletes (4%, p,0.001; Figure). ...
  http://circ.ahajournals.org/content/130/Suppl_2/A18757
*  Abstract 15102: Are T wave Inversions in the Anterior Precordial Leads Benign in African- Americans? | Circulation
Introduction: While it has been proposed that T wave inversions (TWI) in the anterior precordial leads can be a normal finding in the ECGs of Afro-Caribbean athletes, it is uncertain whether this holds true for African-Americans. Hypothesis: TWI in the anterior precordial leads can be a non-specific marker of cardiac disease, and as a result, assuming a benign nature for TWI in the anterior leads in African-American athletes may not be appropriate. Methods: To begin to investigate this notion, we evaluated the incidence of cardiovascular death (CVD) in apparently healthy African- Americans with anterior TWI over an 11 year period. We analyzed the ECGs and CV deaths in 5334 ambulatory African Americans (average age 50 years, 8% female, average follow up of 8 years) seen at the Palo Alto VA Health Care system from 1986 until 1997. T waves were coded as inverted in V2, V3, V4 and V5 if TWI were noted to be more than 1 mm below the PR segment. The leads coded as inverted were summed to create a ...
  http://circ.ahajournals.org/content/126/Suppl_21/A15102
*  Notes from Dr. RW: Cardiac memory phenomenon: a cause of non-ischemic T wave abnormality
Alteration in ventricular repolarization occurs during changes in ventricular activation as may occur with ventricular pacing, bundle branch block and various arrhythmias. This may result in T wave abnormalities which persist following cessation of pacing, resolution of bundle branch block or resolution of arrhythmia. Such changes may be confused with ischemia. The phenomenon, known as cardiac memory, is reviewed here in the American Journal of Emergency Medicine. ...
  http://doctorrw.blogspot.com/2008/04/cardiac-memory-phenomenon-cause-of-non.html
*  the electrocardiograph machine - Steemwiki.info
china 12a electrocardiograph machine 12 channel, used mortara eli 350 ekg machine by mortara model eli 350, quot electrocardiograph machine quot stock photos royalty free, the information is not available right now, electrocardiograph machine instrument co
  http://steemwiki.info/the-electrocardiograph-machine.html
*  Patente US4883064 - Method and system for gathering electrocardiographic data - Google Patentes
A method of gathering electrocardiographic data is disclosed wherein the EKG data is collected by sequentially monitoring the difference in electrical potential measured at each of at least three patient leads for a time period greater than 15 seconds, preferably for equal time periods of 20 seconds each. Although more than three leads and longer monitoring time periods may be used, a 60-second three-lead EKG data sample in accordance with the present invention is clinically sufficient to monitor cardiac function and to diagnose most cardiac dysfunctions. A system for collecting such electrocardiographic data is also disclosed. The system allows the collected data to be stored for later translation and interpretation. The stored data may also be communicated over phone lines for translation and interpretation at a remote site by trained individuals.
  http://www.google.es/patents/US4883064
*  Accuracy of exercise electrocardiography in detecting physiologically significant coronary arterial lesions. | Circulation
The accuracy of exercise electrocardiography in detecting a physiologically significant coronary artery stenosis has been assessed previously by comparing the exercise test with a coronary arteriogram. The inherent inaccuracy of visually determined percent diameter stenosis measurements might have lead to the conclusion that the exercise electrocardiogram was less accurate than it truly was. To determine the accuracy of the exercise electrocardiography in detecting a physiologically significant coronary stenosis, we studied 40 patients with one-vessel, one-lesion coronary artery disease, a normal resting electrocardiogram, and no hypertrophy or prior infarction. Each patient underwent exercise electrocardiography (Bruce protocol) that was interpreted as abnormal if the ST segment developed 0.1-mV or greater depression 80 msec after the J point. The physiological significance of each coronary stenosis was assessed by measuring of coronary flow reserve (peak ...
  http://circ.ahajournals.org/content/83/2/412
*  Normal electrocardiographic findings : recognising physiological adaptations in athletes.
Electrocardiographic changes in athletes are common and usually reflect benign structural and electrical remodelling of the heart as a physiological adaptation to regular and sustained physical training (athlete's heart). The ability to identify an abnormality on the 12-lead ECG, suggestive of underlying cardiac disease associated with sudden cardiac death (SCD), is based on a sound working knowledge of the normal ECG characteristics within the athletic population. This document will assist physicians in identifying normal ECG patterns commonly found in athletes. The ECG findings presented as normal in athletes were established by an international consensus panel of experts in sports cardiology and sports medicine.. ...
  http://gih.diva-portal.org/smash/record.jsf?pid=diva2:662335
*  Transient ECG Changes in Patients With Acute Biliary Disease - Full Text View - ClinicalTrials.gov
Background:. The importance of ischemic ECG changes including St segment elevation, ST segment depression or T wave inversion that indicate myocardial ischemia are well established and require appropriate investigation and treatment.. However, there is an abundance of clinical situation, with apparently ischemic ECG change not indicate traditionally coronary artery related ischemia and therefore require prompt recognition and treatment of underlying condition, that may be serious and life-threatened. For example of such conditions are pericarditis, myocarditis, aortic dissection, electrolyte abnormalities, intracranial hemorrhage and hypothermia.. Together with them, an ECG ST segment changes may appeared in abdominal serious illness such as pancreatitis and cholecystitis(17,18,19,20,23). Whereas in pancreatitis various vasoactive and toxic for myocardium substances released, the cause of ST segment changes in cholecystitis are discussed and includes tachycardia , vagal reflexes, changed in ...
  https://clinicaltrials.gov/ct2/show/NCT01706068?recr=Open&cond=%22Colic%22&rank=19
*  Transient ECG Changes in Patients With Acute Biliary Disease - Full Text View - ClinicalTrials.gov
Background:. The importance of ischemic ECG changes including St segment elevation, ST segment depression or T wave inversion that indicate myocardial ischemia are well established and require appropriate investigation and treatment.. However, there is an abundance of clinical situation, with apparently ischemic ECG change not indicate traditionally coronary artery related ischemia and therefore require prompt recognition and treatment of underlying condition, that may be serious and life-threatened. For example of such conditions are pericarditis, myocarditis, aortic dissection, electrolyte abnormalities, intracranial hemorrhage and hypothermia.. Together with them, an ECG ST segment changes may appeared in abdominal serious illness such as pancreatitis and cholecystitis(17,18,19,20,23). Whereas in pancreatitis various vasoactive and toxic for myocardium substances released, the cause of ST segment changes in cholecystitis are discussed and includes tachycardia , vagal reflexes, changed in ...
  https://clinicaltrials.gov/show/NCT01706068
*  Primary T wave abnormalities caused by uniform and regional shortening of ventricular monophasic action potential in dog. |...
We correlated primary T wave changes with the changes of monophasic action potentials (MAP) recorded with suction electrodes from the ventricular surface of the dog heart following systemic or intracoronary infusions of small doses of isoproterenol (ISP). The portions of the heart perfused with ISP were excised and weighed to determine the mass of perfused tissue. ISP shortened the ventricular MAP by an average of 12-18 msec in the entire ventricular mass following systemic administration, in 34 plus or minus 6 per cent of the ventricular mass after injection into the left circumflex coronary artery (LCA), in 8.5 plus or minus 2.6% of the ventricular mass after injection into a branch of LCA and in 17 plus or minus 8 per cent of the ventricular mass after injection into the right CA. The MAP changes induced by ISP were similar to the transmembrane action potential changes recorded with microelectrodes from papillary muscles excised from the same dogs. The most important results of this study ...
  http://circ.ahajournals.org/content/51/4/668
*  Abstract 18610: Among Several Surface ECG Measurements and Clinical Indicators, Only Tpeak-Tend and Cornell Voltage Predict...
Introduction: Though CAD and depressed LVEF confer high risk for sudden cardiac death due to ventricular tachyarrhythmia, further risk stratification within this population is needed. Surface ECG markers of dispersion of ventricular repolarization, including Tpeak-Tend (Tpe), QTc, and Q-Tpeak, have been suggested as predictors of risk for ventricular arrhythmia. We assessed which of these variables is most powerful for prediction of clinical arrhythmic events in this population, and whether other clinical indicators are more predictive.. Methods: We prospectively evaluated 327 patients (79% M, 67±11 y) with CAD, LVEF ≤35% (mean, 23±7%), and an implanted cardioverter-defibrillator (ICD). Baseline clinical data were collected, and ECG measurements were taken using validated GE Healthcare algorithms. Tpe was corrected for HR via Tpe/√RR (abbreviated Tpec). Follow-up for appropriate ICD therapy for VT or VF was conducted via chart review and device interrogation.. Results: Over a mean ...
  http://circ.ahajournals.org/content/122/Suppl_21/A18610
*  The electrocardiographic differential diagnosis of ST segment depression | Emergency Medicine Journal
Intraventricular conduction delays such as LBBB and the associated ST segment-T wave abnormalities can mimic both acute and chronic ischaemic changes. Much has been written about the evaluation of the ST segment elevation in the presence of LBBB1,8; considering chest pain patients in the ED, LBBB is responsible for 15% of STE syndromes and is the second most frequently encountered electrocardiographic pattern responsible for non-ischaemic STE.17,18 LBBB, however, can also cause significant ST segment depression, and it is imperative that these electrocardiographic changes be distinguished from those that occur in the presence of ACS.3 The "rule of appropriate discordance" states that in LBBB, ST segment-T wave configurations are directed opposite from the major, terminal portion of the QRS complex. As such, leads with either QS or rS complexes should have significantly elevated ST segments mimicking an AMI while leads with a large monophasic R wave demonstrate ST segment depression. T waves in ...
  http://emj.bmj.com/content/19/2/129.full
*  Serial signal-averaged electrocardiography in children after cardiac transplantation.
article{3004d42f-c464-4188-bf60-ba0491925d72, author = {Bennhagen, Rolf and Sörnmo, Leif and Pahlm, Olle and Pesonen, Erkki}, issn = {1399-3046}, language = {eng}, number = {6}, pages = {773--779}, publisher = {Wiley-Blackwell}, series = {Pediatric Transplantation}, title = {Serial signal-averaged electrocardiography in children after cardiac transplantation.}, url = {http://dx.doi.org/10.1111/j.1399-3046.2005.00384.x}, volume = {9}, year = {2005 ...
  https://lup.lub.lu.se/search/publication/148162
*  Signal-Averaged Electrocardiogram | Health Information | MedCentral Health System
Signal-Averaged Electrocardiogram (Signal-Averaged ECG, Signal-Averaged EKG, SAECG) Procedure Overview What is a signal-averaged electrocardiogram? An electrocardiogram (ECG or EKG) is one of the simplest and fastest procedures used to evaluate the heart. Electrodes (small, plastic patches) are placed at certain locations on the chest, arms, and legs. When the electrodes are connected to an ECG machine by lead wires, the electrical activity of the heart is measured, interpreted, and printed out for the ...
  http://www.medcentral.org/Main/StaywellProducts/SignalAveraged-Electrocardiogram-7119.aspx
*  Out-of-Hospital Cardiac Arrest Patients With ST-Segment Elevation on Electrocardiogram | JACC: Cardiovascular Interventions
As an institution that has a great interest in and has studied cardiac arrest and ST-segment elevation myocardial infarction (STEMI) (1), we read with great interest and agree with Dr. Kern (2) that we should provide "operators and medical centers the opportunity to do what is best for the individual STEMI patient, without fear of unfair inflation of their overall reported mortality figures.". We agree that "such a change cannot come too soon" for those cardiac arrest STEMI victims comatose on arrival to the hospital. However, we now fear that with aggressive door-to-balloon-time initiatives and our prior report on STEMI and out of hospital cardiac arrest (OHCA), that operators are performing emergent percutaneous coronary intervention (PCI) too often in comatose patients when STEMI does not in fact truly exist.. A recent abstract from our institution by Abraham et al. (3), presented at the most recent American College of Cardiology Scientific Sessions, noted that aggressive catheterization was ...
  http://interventions.onlinejacc.org/content/4/9/1052
*  Wagner College: EKG Technician Certificate - EKG Technician Schools
This comprehensive 50 hour EKG Technician Certification Program prepares students to function as an EKG Technician. This course will include important practice and background information on anatomy of the heart and physiology, medical disease processes, medical terminology, medical ethics, legal aspects of patient contact, the Holter monitor, electrocardiography and echocardiography.. Additionally, students will practice with equipment and perform hands-on labs including introduction to the function and proper use of the EKG machine, the normal anatomy of the chest wall for proper lead placement, 12-lead placement and other clinical practices. EKG Technicians also analyze printed readings of EKG tests, measuring various "cardiac intervals and complexes" and determining normal vs. abnormal EKG.. EKG Technician Course Outline. ...
  http://www.ekg-techs.com/wagner-college-ekg-technician-certificate/
*  ELI 380 ERGO* - Sword Medical
The latest innovation of the ELI family of resting electrocardiographs by Mortara, the ELI 380 with ERGO display offers an exclusive ergonomic design to assist ECG technicians in streamlining workflow and improving the way they interact with the electrocardiograph as they care for their patients.. The electrocardiograph offers a swiveling and tilting 17-inch touchscreen display that allows the user to maneuver easily, even in tight spaces. Its capacitive touchscreen can be rotated to improve viewing and operation of the electrocardiograph.. In addition to the VERITAS algorithm for ECG interpretation, ELI 380 offers the BEST 10 feature, capable of automatically selecting the best 10 seconds of noise-free ECG within the memory buffer. Together, the Wireless Acquisition Module (WAM), large memory capacity, complete workflow management, bar code support and many other features, make the ELI 380 with ERGO display the ultimate electrocardiograph for today's cardiology departments.. ...
  http://www.swordmedical.ie/product/eli-380-ergo3/
*  Cardiology - Page 2
A 42-year-old man with acute renal failure is confused. His serum potassium is 8.1 mEq/L . The most likely abnormal ECG finding is: a) T wave inversion b) PR interval of 300ms c) QT interval of 0.4s d) U wave e) Tall tented T waves The correct answer is E The earliest ECG evidence of [...]. ...
  http://mcqs.medicalisland.net/category/cardiology-2/page/2/
*  Improving Use of Prehospital 12-Lead Electrocardiography for Early Identification and Treatment of Acute Coronary Syndrome and...
PubMed Central Canada (PMC Canada) provides free access to a stable and permanent online digital archive of full-text, peer-reviewed health and life sciences research publications. It builds on PubMed Central (PMC), the U.S. National Institutes of Health (NIH) free digital archive of biomedical and life sciences journal literature and is a member of the broader PMC International (PMCI) network of e-repositories.
  http://pubmedcentralcanada.ca/pmcc/articles/PMC3103142/?lang=en-ca
*  Dr. Smith's ECG Blog: A Patient with Ischemic symptoms and a Biventricular Pacemaker
KEN GRAUER wrote the following - GREAT case for illustrating a series of important findings and observations during stemi evolution in a patient with a pacemaker. As per Dr. Stephen Smith - Acute STEMI can be diagnosed in some cases of paced rhythms. In addition to assessing for inappropriate discordance - the 1st ECG shown here clearly manifests primary ST segment elevation in many leads, any one of which in an older patient with new-onset worrisome chest pain should by itself be enough to strongly suggest acute evolving stemi. My "Go-To" lead is often lead aVL - which in this case shows subtle but clearly abnormal ST elevation (with beginning T wave inversion). Almost regardless of amount - this shape is highly suspicious. QRS amplitude of the paced complex in lead I is small - but the ST coving and elevation in that lead (which "neighbors" lead aVL) is clearly abnormal. ST segment assessment in the chest leads show typical ST segment shape and elevation characteristic of acute anterior STEMI, ...
  http://hqmeded-ecg.blogspot.com/2016/04/a-patient-with-chest-pain-and.html
*  Emergency coronary stenting of unprotected critical left main coronary artery stenosis in acute myocardial infarction and...
A 66 year old female smoker with no known history of ischaemic heart disease presented to a local hospital with a three hour history of sudden onset, severe central chest pain radiating to the neck and left arm, and associated sweating, nausea, and dyspnoea. She could recall no prior chest pain or shortness of breath and had no other identifiable risk factors for ischaemic heart disease.. Aspirin 300 mg was given in the ambulance. On arrival the patient was clammy, tachycardic (pulse 105 beats/min), and hypotensive (blood pressure 93/66 mm Hg), with normal heart sounds and fine right basal inspiratory lung crepts. Initial ECG showed sinus tachycardia with left axis deviation, partial left bundle branch block, and T wave changes in leads I and aVL. Laboratory findings showed a creatine kinase concentration of 247 U/l, lactate dehydrogenase 310 U/l, and random total cholesterol 5.0 mmol/l. All other blood tests were normal. Non-ST elevation MI was diagnosed, confirmed by a cardiac enzyme series ...
  http://heart.bmj.com/content/89/9/e24.full
*  Signal-averaged electrocardiogram - Wikipedia
Signal-averaged electrocardiography (SAECG) is a special electrocardiographic technique, in which multiple electric signals from the heart are averaged to remove interference and reveal small variations in the QRS complex, usually the so-called "late potentials". These may represent a predisposition towards potentially dangerous ventricular tachyarrhythmias. A resting electrocardiogram (ECG) is recorded in the supine position using an ECG machine equipped with SAECG software; this can be done by a physician, nurse, or medical technician. Unlike standard basal ECG recording, which requires only a few seconds, SAECG recording requires a few minutes (usually about 7-10 minutes), as the machine must record multiple subsequent QRS potentials to remove interference due to skeletal muscle and to obtain a statistically significant average trace. For this reason, it is important for the patient to lie as still as possible during the recording. SAECG recording yields a single, averaged QRS potential, ...
  https://en.wikipedia.org/wiki/Signal-averaged_electrocardiogram
*  The ECG in Myocardial Infarction Dr Stephen Newell - ppt download
The changes in the ECG are seen in the leads adjacent to the infarct. In the first few hours the T waves become abnormally tall (hyperacute with loss of their normal concavity) and the ST segments begin to rise. In the first 24 hours the T wave will become inverted, as the ST elevation begins to resolve. Pathological Q waves may appear within hours or may take greater than 24 hr. Long term changes of ECG include persistent Q waves in 90%, persistent T waves. Persistent ST elevation is rare except in the presence of a ventricular aneursym. In non Q-wave infarcts, ST depression and T wave inversion occur without ST elevation. There may be ST depression in the leads opposite to the site of the infarct. In Type 1 DM a small infarct on ECG may hide large haemodynamic changes. ...
  http://slideplayer.com/slide/2549304/